The fight against the corona virus in Israel: While the congestion in the hospitals continues and after the country’s citizens have been in quarantine for almost two weeks, Prime Minister Netanyahu’s entourage estimates: within three to four weeks, the daily number of infections will drop to about 1,500.
Photo: Moshe Ben Simhon
If the daily number of infections decreases, as is estimated in Netanyahu’s environment, the removal of the restrictions will begin, although they will not be removed in a sweeping manner in order to continue the positive trend up to a level of about 300 infections per day. This assessment was raised this morning (Wednesday) at a discussion by the Ministerial Committee for GSS High School.
According to the Ministry of Health’s proposal, the measure for the transition between stages will be the coefficient of infection. When the coefficient of infection is below 0.8, it will be possible to continue with the steps to open up the economy. Another measure of easing restrictions is a verified percentage of less than 5%.
Earlier today, Minister Yuval Steinitz was urgently summoned to the corona cabinet that has just been convened. Steinitz, who has been warning for months that the government’s policy is too loose, believes the resin for leaving the quarantine should be a maximum of 250 new patients a day. It is estimated that Prime Minister Netanyahu summoned him to a meeting to weigh against ministers who demand a facilitation of the closure.
As mentioned, the Corona Cabinet is convening at this time with the aim of establishing a long-term plan for dealing with the plague. The Prime Minister intends to present a three-stage plan according to which the policy will be implemented in the coming months.
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The first stage is the closure that began on Rosh Hashanah, and he says “it will last a month and maybe much longer.” This is the first meeting of the Committee of Ministers since the strict closure began last weekend.
When the coefficient of infection is below 0.8, it will be possible to continue with the steps to open up the economy. Another measure to alleviate the limitations is a verified percentage of less than 5% (except in the case of low response to the tests) and a decrease in the number of severe patients.
As part of the discussion, Corona Commissioner Prof. Roni Gamzo presented a plan to alleviate the congestion in hospitals. This is an addition of 1,500 beds by October 15 (750 beds by October 5, and another 750 by October 15). 20 percent of those beds are for critically ill patients.
As for enforcement, Projector Gamzo recommended raising the level of fines. If the recommendation is approved, the fines will be doubled and even more. According to Gamzo’s recommendation, the fine for not wearing a mask will increase from NIS 500 to NIS 1,000. The fine for violating the obligation to isolate will increase from NIS 5,000 to NIS 10,000, the opening of an educational or boarding institution whose opening is prohibited – from NIS 5,000 to NIS 50,000 (and the addition of authority to issue closure orders).
The fine for holding prohibited multi-participant events – from NIS 5,000 to NIS 50,000. The fine for opening businesses or public places or businesses whose opening is prohibited by regulations – from NIS 5,000 to NIS 10,000.
At the same time, Finance Minister Israel Katz will demand in the Corona cabinet a gradual return of the private sector that does not receive an audience for full activity, immediately after Sukkot. He will first return to 50% activity and after two more weeks will return to full activity in accordance with the purple mark and the beating heart plan. Katz will also demand the return of early childhood education after Sukkot, according to the morbidity data.
As part of an analysis submitted to the Corona Cabinet by a team of researchers from the Rakah Institute of Physics and the School of Public Health at the Hebrew University and Hadassah, which monitors the corona epidemic, updates were given on the morbidity and mortality expected in various closure scenarios, according to health and public parameters.
Among other things, the possibility arises that this increased mortality is due to a decrease in the performance of the health system, due to the heavy workload created in the hospitals and the medical staff in them or the patients may arrive late to the hospitals or the resources are insufficient for patients’ survival.
Moreover, these days the experts are examining why there has been a significant decrease in the number of days of hospitalization of those who died of corona during the month of September. In a graph published under the heading “Possible indicator of declining health system performance,” the researchers showed that the average number of days until death from the disease dropped from 15 days to about 11 during early September. “This is an indicator of a possible decline in the survival capacity of the health system,” the researchers clarify in their report.
From the morbidity indices, even today it seems that the closure, which began about ten days ago, still does not show sufficient effect. “The inefficiency (of the quarantine) may be due to infection in the home, but it will certainly require an extension of the quarantine to obtain a satisfactory effect,” the researchers note in the report.
The researchers addressed a possible gradual exit from the quarantine below. The researchers emphasize that there is great importance in driving out of quarantine using many metrics, related not only to the number of verified infections daily, but also to trends in severe morbidity, and the performance of the epidemiological array, and its grip capabilities in infection chains.
Now the overarching goal, for them, is to reach morbidity levels that will allow for “isolation and extinction of outbreaks,” that is, the formation of a life alongside the disease until a medical solution such as a vaccine or drug is found.
Immediately, the researchers hope to reach a daily multiplication coefficient of less than 0.9 while maintaining its ability over several weeks. Reaching a daily coefficient of 0.9, they claim, will allow suppression of the current corona wave within three weeks. “In order to stabilize the routine of life during the outbreak, it is possible to consider a return of the education system in lower grades only and in non-‘red ‘areas in capsules with staff separation (unlike what was done), and resumption of national economic activity without gatherings indoors and without exceptions similar to’ red areas’. “, Reads the document.
The experts who signed the new report are Prof. Yinon Ashkenazi, Prof. Doron Gazit and Prof. Nadav Katz of the Rakach Institute of Physics, together with Prof. Ronit Calderon-Margalit and Prof. Ran Nir-Paz of the School of Public Health and Community Medicine at the Hebrew University of Jerusalem and Hospital Hadassah.
The congestion in the hospitals continues
At the same time, according to a disease data report published by the General Medicine Division of the Ministry of Health’s Medical Division, occupancy in three hospitals in Israel – Hadassah, Kaplan and Assuta, has exceeded 100 percent and the wards are full. Occupancy at Galil Medical Center in Nahariya is 87 percent , Shamir-Assaf Harofeh Medical Center with 89 percent and Barzilai Hospital in Ashkelon with 96 percent. Meanwhile, 823 patients are hospitalized in critical condition, of whom 204 are respirated.The death toll since the outbreak of the virus in Israel stands at 1,544, of which 596 in September.
The meeting was also attended by Defense Minister Bnei Gantz, Health Minister Yuli Edelstein, Justice Minister Avi Nissenkorn, Foreign Minister Gabi Ashkenazi, Minister of Intelligence Cohen (who heads the committee to examine the issue of placements), Energy Minister Yuval Steinitz and Minister of Higher Education Zeev Elkin. In addition to them, the head of the GSS against Argaman and senior officials in the Ministry of Justice and the Privacy Protection Authority also attended the meeting.
Meanwhile, Communications Minister Joaz Handel presented a seven-step plan to get out of the corona crisis. “Enough with the games, sanity is required – for a week now we have been dealing absurdly only with what demonstrations and prayers look like instead of building a strategy to get out of this huge crisis,” he said.
In the first step proposed by Handel, the Corona Cabinet will be reduced to only four participants – the prime minister, the deputy prime minister and two other ministers. According to the second step in the Minister’s plan, the discussions on the subject will be filmed and broadcast, with the exception of discussions that will be defined as sensitive, in addition to researching results that will be published once a week.
Enough with the games, sanity is required.
For a week now, we have been absurdly dealing only with what demonstrations and prayers look like, instead of mainly – building a strategy to get out of this huge crisis.
It’s time to put an end to this – 7 necessary steps that I will fight in the government >>
– Yoaz Lever יועז (@ YoazHendel1) September 30, 2020
In the third step proposed by Handel, the Corona Commissioner and the Corona Cabinet will present disease targets and exit channels for each decision made, and these will be made public. In addition, the government will report weekly on the progress of virus treatment. The next step involves the establishment of a “red team” with experts who will examine the work of the Corona cabinet – and even present alternatives to it. Afterwards, Handel points out that hospital administrators will regularly report bed occupancy and the rate of morbidity in their workplace.
Under the sixth step, the chairman of the opposition and the chairman of the Corona Committee will be invited to receive an update in the Corona Cabinet once a week. The seventh and final step includes a complete closure that the government will decide on “until the level of morbidity is reduced.” According to Handel, “These measures will remain in force until the level of morbidity is returned to the level of 100 patients per day, and will be reactivated if the morbidity rises above 1,000 patients per day once again. “
Ashkenazi: “There was no escape from a full locksmith”
Minister Ashkenazi referred to the national closure, saying that the various restrictions will be removed and the economy will be reopened to activity as soon as possible. “We are here on complex days when Israel is in a health battle and has to make painful concessions, including waiving personal contact with our parents, grandparents,” Ashkenazi said at a signing ceremony with the governments of Nepal and Georgia to add nursing staff to care for the elderly and mentally debilitated population:
“The Israeli government has approved a state of emergency and a complete closure, from which there was no escape, knowing full well that these regulations have restrictions that could violate basic fundamental rights,” Ashkenazi added. “The extent of morbidity and the burden on hospitals do not allow us to make other decisions. We must prevent public gatherings in any way in order to regain control of the disease.”
Meanwhile, the Ministry of Health announced today that 4,949 people were diagnosed yesterday as positive for the corona virus out of 34,352 tests performed. The number of positive tests continues to be high and stands at 15%. 1,589 patients are currently hospitalized in Israeli hospitals. 810 in critical condition, of whom 205 were respirated and 293 in moderate condition. The death toll from the onset of the epidemic has risen to 1,547, after another 12 people have died since midnight. A total of 239,222 infected people have been identified in Israel so far, of whom 64,608 are active patients.
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